Vertebral fractures affect functional status in postmenopausal rheumatoid arthritis patients

• Published in: Journal of bone and mineral metabolism Vol. 32; no. 6; pp. 725 - 731
• Main Authors: Omata, Yasunori, Hagiwara, Futoshi, Nishino, Jinju, Matsudaira, Ko, Kadono, Yuho, Juji, Takuo, Mori, Toshihito, Nakayama, Hisanori, Nagase, Yuichi, Hirose, Jun, Yasui, Tetsuro, Matsumoto, Takumi, Matsui, Toshihiro, Tohma, Shigeto, Tanaka, Sakae
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.11.2014; Springer Nature B.V
• Subjects: Aged; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - adverse effects; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - metabolism; Bone Density; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - adverse effects; Cholecalciferol - administration & dosage; Cholecalciferol - adverse effects; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Female; Femur Neck - diagnostic imaging; Femur Neck - metabolism; Humans; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Original Article; Orthopedics; Postmenopause; Prednisolone - administration & dosage; Prednisolone - adverse effects; Radiography; Spinal Fractures - diagnostic imaging; Spinal Fractures - epidemiology; Spinal Fractures - metabolism; Spinal Fractures - prevention & control; Vertebral fracture; Osteoporosis; Rheumatoid arthritis; Prednisolone; Quality of life
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-013-0552-8

Functional disability is a major concern in patients with rheumatoid arthritis (RA). This retrospective study investigated the risk factors for vertebral fractures (VFs) in postmenopausal RA patients and determined the impact of VFs on functional status. Data from a cohort of 200 postmenopausal RA patients in a single hospital registry were analyzed. Demographic and clinical data, imaging data from spine radiographs, and bone mineral density (BMD) data were collected from the patients at baseline and at the final visit (a mean of 2.9 years after the first visit). Risk factors for incident VFs and their impact on the modified health assessment questionnaire (mHAQ) were analyzed. Twenty-eight patients (14 %) developed new VFs (NVFs). Logistic regression analysis adjusted for age, BMI, and disease duration revealed that daily dose of prednisolone, femoral neck BMD, use of active vitamin D 3 , and use of a bisphosphonate at baseline were factors associated with NVF, with odds ratios (95 % confidence interval) of 1.27 (1.05–1.54), 0.94 (0.91–0.97), 0.34 (0.13–0.89), and 0.31 (0.12–0.82), respectively. Patients with NVF exhibited worse mHAQ scores and a greater increase in mHAQ scores from baseline compared with those without NVF. In conclusion, incident VFs were associated with reduced functional status in postmenopausal patients with RA. It is important to prevent VFs to maintain the functional status of RA patients.